The field of the present invention is related to the treatment of tissue with energy, and more specifically to the treatment of an organ such as the eye with fluid stream energy.
Prior methods and apparatus of treating subjects such as patients can result in less than ideal removal in at least some instances. For example, prior methods of eye surgery can result in longer healing time and less than desirable outcome than would be ideal in at least some instances.
Prior methods and apparatus of imaging tissue can be less than ideal for imaging a treated tissue. For example, prior ultrasound methods and apparatus may not be well suited to view the treatment sight during treatment, and alignment of diagnostic images with treatment images can be less than ideal. Also, at least some of the prior treatment methods and apparatus of treating tissue may not be well suited from combination with imaging systems of the prior art. In at least some instances, it would be helpful to provide improved imaging of tissue during surgery, for example to provide real time imaging of tissue that would allow a user to adjust the treatment based on real time images of the tissue. At least some of the prior methods and apparatus to image tissue during surgery can be somewhat cumbersome to use, and can result in delays in the patient treatment.
Prior methods and apparatus to treat an organ such as the eye may provide a user interface that is somewhat cumbersome for the user, and can provide less than ideal planning of the surgery. Also, at least some of the prior methods and apparatus to treat tissue such as the eye tissue can be somewhat less accurate than would be ideal. In at least some instances, the prior methods and apparatus may provide a less than ideal user experience. Also, at least some of the prior interfaces may provide less than ideal coupling of the treatment apparatus with tissue structures.
Prior methods and apparatus of removing the lens of the eye can be less than ideal in at least some instances. Although phaco emulsification ultrasound probes have been proposed to remove cataract tissue, such probe can damage the corneal endothelium and may provide less than ideal results in at least some instances. Although lasers can be used to cut the lens capsule and remove the lens of the eye, such lasers can be time consuming and may not ideally remove at least some tissues of the eye. At least some patients may develop a secondary cataract in the posterior capsule subsequent to removal of the lens with prior devices, which may require a secondary treatment.
Prior methods and apparatus of treating glaucoma can be less than ideal in at least some instances. The amount of pressure reduction with the prior devices can be less than ideally predictable, and patients may have too little reduction in intraocular pressure, or to great of a reduction. Also, the eye can heal, resulting in decreased efficacy in at least some instances. For example, a trabeculectomy can be performed to provide a drainage channel, the channel can fill in the surgical opening such that drainage may be less than ideal.
It would be desirable to provide improvements to assist in more accurate tissue removal in both fully automated and physician assisted operating modes. At least some of these objectives will be met by the inventions described hereinafter.